Probing the Unconscious Rather than Suicide

I would like to add to the symposium papers from the point of view of a clinician who also did some research on the history of the concept of the death drive. As is well known, there are many layers in Freud’s proposal of a death drive, from biological to philosophical ones. However, besides focusing on aggression turned outward, he wanted to do justice conceptually to clinical facts—in our case to self-destructive clinical phenomena—with which he was confronted in his practice. His clinical experiences required, finally, something “beyond the pleasure principle.” Later he would ascribe it to some resistance and that it needed such a long time before he decided to recognize an aggressive instinct.

In my view, the choice to name it “death drive” is psychologically understandable, but unlucky: it served as a suitable container for clinical experiences of destructiveness in the analytic relationship. On the one hand, as I imagine it, unavoidable, direct experiences of something deathly (in the most varied forms and manifestations) were in a sense pressing—along with the relevant observations in the analytic situation—for adequate representation. On the other hand, it fostered and continues to foster misunderstandings. So Freud initially suggests “dealing with it” in a tangible biological or physiological/physical way instead of examining how far analogies from this domain may or may not be helpful as necessary in understanding clinical phenomena.

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In The Ego and the Id (1923), the connection with the clinical practice became clearer. Freud illustrates the connections especially impressively with melancholia, in which the excessively strong superego, having overtaken consciousness, is said to rage against the ego with merciless violence, as if it had seized all the sadism available in the individual, now reigning in the superego, as a pure culture of the death drive (53). He had actually addressed that area years before, in Mourning and Melancholia (1917), which was the beginning of a theory about the internal world peopled by primitive internal figures. It is this concept that I find helpful in dealing with patients suffering from suicidal ideation. Of course, in the meantime there was further conceptual development to capture more precisely those kinds of dynamics in the internal world. One strain of thought consists of describing the complexities in the form of different “organizations,” namely narcissistic ones.

Herbert Rosenfeld gave a very detailed analysis of this process, which he termed “destructive narcissism.” In A Clinical Approach to the Psychoanalytic Theory of the Life and Death Instincts: An Investigation into the Aggressive Aspects of Narcissism (1971), Rosenfeld most impressively delineated how, for example, an internal mob/gang/mafia dominates the situation all powerfully as a cruel part of the self, staying alive by idealization and brute force, enticing with false promises, and thus impeding the development of the libidinous self. Such patients are inexorably drawn into a perverse world where life and sanity, regarded as evidence of weakness, are treated with contempt.

According to Rosenfeld, it is essential “to help the patient to find and rescue the dependent sane part of the self from its trapped position inside the psychotic narcissistic structure” (1971, 175). He went on to say that “Secondly, it is important gradually to assist the patient to become fully conscious of the split-off destructive omnipotent parts of the self which control the psychotic organization, because this can only remain all-powerful in isolation” (175).

Rosenfeld also applied this model in trying to understand what happened in Nazi Germany and to describe the kind of psychic work that was needed during the decades thereafter. As I take it, this model helps us to get a hold of the disquieting dynamics individually and socially. I limit myself here to give an idea of the first by describing the analysis of Mr. B, who again and again felt suicide to be “the only solution.” My patient had been in a leading business position and his high-risk work strategy had meant that the

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company was going to assist him in “business” and send in someone to work with him “side by side.” This had been unacceptable to him and he had resigned in “mutual agreement.” In a panic that his feelings of revenge might lead him to suicide, he went into the hospital (for a few weeks) immediately after emptying his office. This gave him some relief, but no greater perspective.

He explained that he had lived for the company and neglected his wife and family. Now he felt he was a “social parasite” and “useless flotsam,” the kind of person for whom he had utter contempt and treated badly. Each glance by anyone in his hometown confirmed and strengthened this view of himself. He had always taken risks. As a child and adolescent, he had always been the “smallest and skinniest,” but he never shied away from physical fights, although he always lost. Mr. B took part in the most daring tests of courage, such as jumping off a bridge fully clothed, which nearly cost him his life. He was the only one who had jumped.

Almost as an aside, he let me know that at the end of the war, his mother had fled from East Germany to Northern Germany with him in “a box.” They found refuge with a family of a businessman, where they were tolerated rather than welcomed. He “followed” the businessman’s children, who were significantly older than him. I understood the strength of feeling with which he wanted to be part of something; he hated his feeling of being small (concretely and metaphorically) as a life-threatening and isolating weakness. On one level, he seemed to have conquered this weakness with his risky actions, but deep inside him he had the lurking knowledge that he was not one of the “real” children of this businessman. This to him meant that he had no home, and was abandoned and useless ballast. When I addressed this, he let me know that he had called the businessman “father” until he was 15, although his real father had long since returned after being a prisoner of war, having found work in the businessman’s company.

In analysis, he demonstrated an attachment to me alongside our formal business relationship. He was determined to do analysis, but told me in the first few sessions how much he felt robbed of the use of his eyes as weapons because he could not see me as he lay on the couch. This use of his eyes had prevented him from seeing an ophthalmologist, although his vision had deteriorated for some time as he feared paranoid revenge, i.e. that—as a punishment—the doctor would damage his eyes instead of curing them.

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It was only after I addressed his fantasies and his self-destructive behavior that he could deal with this and have an operation. He expressed his appreciation in the following way: “You sometimes say something that annoys me because I can’t avoid recognizing some truth in it.” Gradually, he began to be more observant and perceptive.

Full of astonishment, he told me about the old women on the bus on the way to his analysis, who talked in an engaged and cultivated way about topical political issues. For him, age meant “grey, lifeless, and useless.” He also had “empathic” thoughts about a down-and-out person, whom he frequently saw on his way. He dared to make short errands into town and slowly managed to increase his internal and external scope. The sessions became the “high point” of the day for him. But in his experience this meant “giving too much of himself,” so that he had to curtail this growing relationship with a kind of business relationship.

Mr. B started the session by stating that he was all set to end therapy. I interpreted that he felt driven by something inside him to break off, that it was his attempt to assuage his deep panic that he might be caught unawares, being shown the door. He could tell me that this was “his way” of dealing with his wish to be part of something and then finding out that he was not; he tried to establish clarity. For the first time, Mr. B talked about the possibility that he might have been happier not to be at the top of a business, but “one step below.” But nothing could be done about that now. He was touched by my thought that here too he felt he did not have to force things “to the top,” but could be one step below. He said that the “gut feeling” on which he usually relied was absent and the brutality came from the head. Then he became somewhat insecure. I said that he seemed to question whether or not he should leave it to this brutality. The patient used the word “brutality” for breaking off his analysis from one moment to the next, which he felt on one level to be a “brutal stop,” doing violence to his infantile part.

Mr. B had come to analysis with an overpowering pathological superego organization, to whose cold un-forgivingness he felt exposed to following a professional failure close to retirement age. He now found himself in the same position as those people for whom he had held contempt and treated badly. Mr. B had always thought to attain a superior position in relation to other people, which meant that he had to drop people mercilessly, take revenge for earlier humiliations, etc. When he was in distress, there

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was no internal opposition to his seeking help. But as soon as he had more room to breathe, this was no longer tenable. The more his instinctual drive for pleasure came to the fore, the more exposed he felt. He spoke with self-contempt of being a vulnerable “mimosa.” He knew that I saw this differently and profited from this in an underhand way. He began to feel visibly and noticeably better. Suicide was no longer the (imagined) “solution.” I would like to suggest that a view of seeing the internal world as complex organizations, in which a shift of the self-destructive balance might open a way out, and could also fruitfully be applied to the social level.

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